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Tunnelled Catheter in Children: What to Expect at Home

Common insertion sites for a tunnelled catheter

Your Child's Recovery

Your child had a procedure to place a tunnelled catheter. The catheter is a soft, flexible tube that runs under your child's skin, usually from a vein in the chest or neck to a large vein near the heart. Your child may have it for weeks, months, or longer.

Your child will now be able to get medicine, blood, nutrients, or other fluids with more comfort. Your child will not be poked with a needle every time.

You can use your child's catheter right away. You will be shown how to use it and how to care for it.

Your child's doctor will tell you how to care for the incision at the insertion site. (It's usually on your child's neck.) It may have stitches, strips of tape, or a gauze dressing. Your doctor will tell you when the stitches will be removed. The strips of tape will fall off in 3 to 5 days. If there is a gauze dressing, it can be removed after 2 days.

Your child's doctor will tell you how to care for the incision on your child's chest where the catheter is. It will likely have a clear or gauze dressing on it. A clear dressing usually needs to be changed about 2 days after the procedure and then once a week. It may need to be done sooner if you can't see the insertion site, if the dressing becomes soiled, or if the dressing falls off. A gauze dressing needs to be changed 2 or 3 times a week. Also, change the dressing right away if it becomes wet, loose, or dirty.

Under the skin, there may be a small ring, or cuff, on the catheter. This helps hold the catheter in place.

This care sheet gives you a general idea about how long it will take for your child to recover. But each child recovers at a different pace. Follow the steps below to help your child get better as quickly as possible.

How can you care for your child at home?

Activity

Talk to your child's doctor about what activities your child can do. Your child may not be able to do sports or exercises that use the upper body, such as tennis or basketball.
Avoid arm and upper body movements that may pull on the catheter.
Your child will probably need to take 1 day off from school and will be able to return to normal activities shortly after. This depends on the type of activities your child does, why your child has the catheter, and how your child feels.
Your child may shower 24 to 48 hours after surgery, if the doctor okays it. Cover the area and catheter so they don't get wet. Pat the cut (incision) dry. Don't go swimming.

Medicines

The doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about taking any new medicines.
Be safe with medicines. Read and follow all instructions on the label.
- If the doctor gave your child a prescription medicine for pain, give it as prescribed.
- If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.

Incision care

Your child's doctor will tell you how to care for the incision at the insertion site. (It's usually on your child's neck.) It may have stitches, strips of tape, or a gauze dressing. Your doctor will tell you when the stitches will be removed. The strips of tape will fall off in 3 to 5 days. The gauze dressing can be removed after 2 days.
Your child's doctor will tell you how to care for the incision on your child's chest where the catheter is. It will likely have a clear or gauze dressing on it. A clear dressing usually needs to be changed about 2 days after the procedure and then once a week. A gauze dressing needs to be changed 2 or 3 times a week. Also, change the dressing right away if it becomes wet, loose, or dirty.

Other instructions

Wash your hands and wear medical gloves when caring for your child's catheter.
Flush the catheter on a schedule, at least once a week. This keeps it open. A nurse or other health professional will teach you how to flush it. Don't force the fluid into the catheter. If it's hard to flush, call the doctor.
Change the dressing and the needleless connector on the catheter as needed. A member of your care team will show you how to change them.
If the catheter breaks, follow the instructions your doctor gave you. If you have no instructions, clamp or tie off the catheter. Then see a doctor as soon as you can. Talk to the nurse or other care giver about an emergency kit to use if the catheter breaks.
Don't let your child wear jewellery, such as necklaces, that can catch on the catheter.
Try to keep the area dry. When your child showers, cover the area with waterproof material, such as plastic wrap.
Never touch the open end of the catheter if the cap is off.
Never use scissors, knives, pins, or other sharp objects near the catheter or other tubing.
If the catheter has a clamp, keep it clamped when you aren't using it.
Fasten or tape the catheter to your child's body to prevent pulling or dangling. Use the device that comes with your child's catheter to hold it in place.
Avoid clothing that rubs or pulls on the catheter.
Avoid bending or crimping the catheter.
Always wash your hands before you touch the catheter.
Put loose clothing over the catheter for the first 10 to 14 days. When getting dressed, your child should not pull on the catheter.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

Your child passes out (loses consciousness).
Your child has severe trouble breathing.
Your child has chest pain, is short of breath, or coughs up blood.

Call your doctor or nurse advice line now or seek immediate medical care if:

Your child has symptoms of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
Your child has blood draining from the area near the catheter.
Your child has swelling in the face, chest, neck, or arm on the side where the catheter is.
Your child has signs of a blood clot, such as bulging veins near the catheter.
Your child's catheter is leaking, cracked, or clogged.
You feel resistance when you inject medicine or fluids into the catheter.
Your child's catheter is out of place. This may happen after severe coughing or vomiting or if you pull on the catheter.

Watch closely for changes in your child's health, and be sure to contact your doctor or nurse advice line if:

You or your child has any concerns about the catheter.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter T440 in the search box to learn more about "Tunnelled Catheter in Children: What to Expect at Home".

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